Mennatallah Abdelgawad

Thesis: Developing and Validating a Social-Determinants–Informed Patient-Reported Outcome Measure of Medication Management and Adherence in Adults with Multiple Long-Term Conditions

This project will develop and validate a Patient-Reported Outcome Measure (PROM) of medication management and adherence for adults living with multiple long-term conditions (MLTC). Adherence is usually treated as individual behaviour, yet it is strongly shaped by social factors: income, housing, transport, education, and health literacy all affect whether someone can attend appointments, afford prescriptions, or follow treatment. These social determinants of health (SDoH) contribute to persistent inequalities in how well people manage their conditions. Although NICE recommends patient-reported tools to support person-centred care, widely used measures such as the Morisky and Medication Adherence Report Scales focus on the individual and overlook social barriers. Frameworks such as the WHO SDoH Framework and Health Capability Theory link social conditions to medication access, but none has a validated clinical tool that health services can act on. An advisory group spanning sociology, social policy, health economics, social care, PRO methods, and public involvement will guide this multi-phase, mixed-methods study. It will explore how SDoH affects medication management in adults with MLTC, how existing PROMs capture or overlook social influences, and which domains best reflect patients' lived experience of SDoH-related barriers. An evidence synthesis will be followed by qualitative work with patients and carers, informing a conceptual framework from which items will be drafted, refined through cognitive interviews, and psychometrically evaluated. The resulting PROM aims to help clinicians distinguish social from clinical barriers, inform referral to community support, and contribute to wider debates on health inequalities and equitable care.

Biography:

I am an ESRC-funded PhD student at the University of Birmingham, based at the Centre for Patient Reported Outcome Research (CPROR) and funded through the Midlands Graduate School DTP. My research explores how social determinants of health shape medication management and adherence among adults living with multiple long-term conditions. After completing my BSc in Pharmaceutical Sciences at Misr International University, I worked as a pharmacist in Egypt for nearly 15 years, progressing from community pharmacist to pharmacy director and branch manager, with a spell in pharmaceutical quality control. Counselling patients with chronic conditions, I saw first-hand that difficulties with medicines were often shaped by cost, access, and everyday life rather than forgetfulness alone. This is what drew me into public health research. I completed an MBA in Health Economics, followed by an MSc in International Public Health at Liverpool John Moores University with Distinction, where my dissertation examined health literacy, self-management, and quality of life among people with diabetes. I then worked as a research assistant in evidence synthesis at the LJMU Public Health Institute, contributing to mixed-methods systematic reviews on health inequalities and family wellbeing, supporting policy analysis for Public Health Wales, and delivering postgraduate research methods teaching. I also completed an MSc in Clinical Epidemiology and Clinical Trial Management at Suez Canal University, where my thesis was a systematic review of insulin resistance genetic polymorphisms and obesity-related breast cancer. My PhD brings these clinical, epidemiological, and public health perspectives together to better understand medication adherence in multimorbidity.

Publications:

1.Abdelgawad MM, Ameen AE, Dandash KM. The Association of Insulin Resistance Genetic Polymorphisms with Obesity-Related Breast Cancer: A Systematic Review. Suez Canal University Medical Journal. 2026 Aug 31;29(8):1-1. Available from: https://doi.org/10.21608/scumj.2026.523505.1818

2.Jones, L., Harris, J., Abdelgawad, M., Booth-Rosamond, A., Smith, E., McCoy, E., Ashworth, E. and Quigg, Z., 2025. A mixed-methods systematic review: Parenting and whole-family interventions for families with multiple and complex needs with children and young people 11 to 19.

3.Jones L, Abdelgawad M., Bellis M. Identifying Policy Options to Tackle Health Inequalities: Policy Analysis and Opportunities for Learning for Wales. Public Health Wales; 2025 May 1. Available from: https://phwwhocc.co.uk/resources/identifying-policy-options-to-tackle-health inequalities/

4.Jones L, Harris J, Booth-Rosamond A, Abdelgawad M., McCoy E, Butler N, Ashworth E, Brookes L, Quigg Z. A Mixed-Methods Systematic Review: The Impact of Mentoring and Befriending Practice and Interventions for 'At Risk' and Care-Experienced Children and Young People. Foundations; 2025 Apr 8. Available from: https://foundations.org.uk/our-work/publications/mentoring and-befriending-practice-interventions-at-risk-and-care-experienced-children young-people-systematic-review/

5.Abdelgawad M. The impact of health literacy on diabetic patients’ quality of life through self-management, self-care behaviours and glycaemic control in Eastern Mediterranean Region: A systematic review. Public Health Institute Journal. 2024 May 21. Available from: https://openjournals.ljmu.ac.uk/PHIJ/article/view/2388

Applied Health

University of Birmingham

2026 Cohort

Mennatallah Abdelgawad | LinkedIn

Supervisors:

Professor Melanie Calvert

Dr Sarah Hughes

Professor Devin Peipert